Question

I am 52 years of age and feel nervous and very confused about the chest pains I am having. Not sure whether they are heartburn or is it perhaps my heart? I have had an EKG.

Answer

We can appreciate your nervousness about your pains as 'heartburn' and heart pain or angina can be similar. We would, however, advise you to be guided by your physician who will have by now the results of your EKG so can explain to you what it means, but who also knows you, your medical history and presenting symptoms. An electrocardiogram ( EKG/ ECG) is an electrical recording of the heart and is used in the investigation of heart disease. It is a very reliable test for detecting abnormalities. However, if you remain concerned, there are other tests a cardiologist can perform to out rule a cardiac or coronary artery disease (CAD) problem. We will explain to you what Heartburn and Heart Pain or Angina mean, which may be helpful to you.
 

HEARTBURN is a pain behind the breast bone, often described as 'burning' in quality. Pain can also be felt at the same level in the mid-line of the back. Most people suffer from heartburn at one time or another. In fact heartburn has nothing to do with the heart - it is a digestive problem. Heartburn is generally related to meals and posture and can often be relieved by remedies for indigestion. There are several causes of heartburn / acid reflux The main offenders are: Coffee, tea, and other drinks that contain caffeine - Chocolate - Fried and fatty foods - Tomatoes and tomato-based products -Alcohol. Finding out what these are can help you make changes in your lifestyle and habit so you can prevent the acid reflux from happening. Gastro esophageal reflux disease(GERD) is the condition where degree of exposure of esophageal mucosa to gastric contents is greater than normal. The most common symptom is heartburn but patients may have other symptoms. When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn.
 

PAIN from the HEART (Heart Pain) is also felt in the chest and sometimes in the upper abdomen. There are two kinds of heart pain. The first, angina, is a pain in the chest due to a temporary shortage of oxygen being carried in the blood to the heart muscle. Angina should be suspected if the chest pain is brought on by exercise and relieved by rest. The second is the more severe and prolonged pain of a heart attack. A heart attack should be suspected if the pain is felt intensely in the centre of the chest, spreading perhaps to one or both arms (especially the left) and into the lower jaw; or feels like a heavy pressure or is 'vice-like'.
 

Many factors increase the risk of developing heart disease, coronary artery disease (CAD) and stroke. They include: family history of premature coronary heart disease, high levels of cholesterol in the blood, diabetes, menopause without estrogen replacement therapy, smoking, high blood pressure (hypertension), sedentary lifestyle, obesity, and poor stress management. In some cases, atherosclerosis cannot be prevented. Atherosclerosis is a common disorder of the arteries. Fat, Cholesterol and other substances accumulate in the walls of arteries and form "atheromas" or plaques.
 

Although you cannot change your age, gender, or family history, you can take steps to lower the other risks. There are important lifestyle changes necessary to preserve optimum health. One should adhere to a healthy diet, free of saturated fats and cholesterol, and containing plenty of fibre (as found in fruits, vegetables and cereals). Also of importance is Regular physical exercise, losing extra weight, and maintaining normal weight. Also Stress management, NO smoking, and no more than 1-2 glasses red wine daily are best. The links below may be helpful to you in learning more about angina, heart attack risks and causes of Heartburn.
 

Related Links
Causes of Heartburn
Heartburn and Gastroesophageal Reflux Disease (GERD)
What's Your Risk of Having a Heart Attack?
Angina
How to choose low-fat food